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Driving performance in adults with ADHD: Results from a randomized, waiting list controlled trial with atomoxetine

Published online by Cambridge University Press:  15 April 2020

E. Sobanski*
Affiliation:
Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, University of Heidelberg, J 5, 68159Mannheim, Germany
D. Sabljic
Affiliation:
Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, University of Heidelberg, J 5, 68159Mannheim, Germany Ruprecht-Karls-University Heidelberg, Department of Legal and Traffic Medicine, Voßstr. 2, 69115Heidelberg, Germany
B. Alm
Affiliation:
Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, University of Heidelberg, J 5, 68159Mannheim, Germany
R.W. Dittmann
Affiliation:
Central Institute of Mental Health Mannheim, Eli Lilly Endowed Chair for Paediatric Psychopharmacology, Department of Child & Adolescent Psychiatry, Medical Faculty Mannheim, University of Heidelberg, J 5, 68159Mannheim, Germany
P.M. Wehmeier
Affiliation:
Central Institute of Mental Health, Department of Child and Adolescent Psychiatry, Medical Faculty Mannheim, University of Heidelberg, J 5, 68159Mannheim, Germany Vitos Hospital for Psychiatry and Psychotherapy, Weilstr. 10, 35789Weilmuenster, Germany
G. Skopp
Affiliation:
Ruprecht-Karls-University Heidelberg, Department of Legal and Traffic Medicine, Voßstr. 2, 69115Heidelberg, Germany
P. Strohbeck-Kühner
Affiliation:
Ruprecht-Karls-University Heidelberg, Department of Legal and Traffic Medicine, Voßstr. 2, 69115Heidelberg, Germany
*
*Corresponding author. Tel.: +49 621 17032852; fax: +49 621 17032855. E-mail address:[email protected] (E. Sobanski).
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Abstract

Purpose:

To investigate effects of a 12-week treatment with atomoxetine (ATX) on driving performance in real traffic, driving-related neuropsychological performance tests and self-evaluation of driving in adult patients with ADHD compared to an untreated control group with ADHD.

Methods:

Parallel group design with an ATX and a waiting list group. At baseline and endpoint patients were evaluated with a standardized on-road driving test (SDBO), a driving-related neuropsychological test battery (Act and React Test System [ART2020]), and subjective measures of driving performance (one-week driving diary, Driver Coping Questionnaire).

Results:

Forty-three of the 64 included patients completed the study (n = 22 ATX, n = 21 controls). Mean intervention period was 11.9 ± 3.0 weeks, mean daily ATX dosage was 71.6 ± 14.9 mg. At endpoint, 60.1% of patients treated with ATX and 0% of waiting list group had reduced ADHD symptoms by greater or equal to 30%. In SDBO, ATX group reduced driving errors in three of four driving performance categories (attention, P < 0.05; risk-related self-control, P < 0.005; driver skills, P < 0.001), number of driving errors remained stable in control group. At endpoint, 47.6% of control group and 18.2% of ATX group (P < 0.05) did not fulfil the driving fitness criteria according to German Guidelines (percentile rank less or equal to 16 in one or more subtests in ART2020). Total number of self-reported critical traffic situations decreased from 12.0 to 6.8 per week in ATX group (P < 0.05) and remained stable in controls by 9.3 and 9.9 at baseline and endpoint (ns). Coping strategies with stressful traffic situations did not change within both groups.

Conclusion:

Our study provides first evidence that treatment with ATX improves driving performance in real traffic in adults with ADHD.

Type
Original article
Copyright
Copyright © European Psychiatric Association

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